Changing patterns of caesarean section.

There has been a substantial rise in the rate of Caesarean section in the last 20 years. There are many reasons for this increase, but it has been argued that the fall in perinatal mortality justifies a higher Caesarean section rate. In this retrospective study 7,274 deliveries were reviewed and 650 Caesarean sections were analysed. There was only a marginal increase in the rate of Caesarean section (1.9%) during the 2 biennial periods studied (1974-1975 and 1984-1985), but overall perinatal mortality rate dropped by half during the second study period. This study confirms that in recent years the indications for Caesarean section have altered, but the marked rise in the Caesarean section rate cannot be explained purely on medical grounds and is certainly not solely responsible for the very significant drop in the perinatal mortality rate.